Royal Blackburn Hospital, East Lancashire Hospitals NHS Trust, Blackburn, UK.
Lancaster Medical School, Furness College, Lancaster University, Lancaster, UK.
Int J Med Robot. 2022 Aug;18(4):e2407. doi: 10.1002/rcs.2407. Epub 2022 Apr 23.
We describe the technical operative details of the robotic repair of a type II endoleak (T2E) following endovascular abdominal aortic aneurysm repair (EVAR). We demonstrate that indocyanine green (ICG) can be used intra-operatively to demonstrate perfusion of the colon following ligation of the inferior mesenteric artery (IMA) vessel feeding the aneurysm sac.
A 74-year old male underwent EVAR for a 5.8 cm infra-renal abdominal aortic aneurysm using an E-Tegra, Jotec Device (JOTEC Gmb, Lotzenäcker 23,D-72379 Hechingen). Surveillance contrast CT (CTA) over the ensuing 30 months confirmed progressive sac expansion.
ICG confirmed colonic perfusion via the marginals after IMA ligation. Total operative time 56 min < 50 mls blood loss and 1-day hospital stay. 3-month follow-up: CTA and ultrasound demonstrated complete resolution of T2E and adequately perfused colon.
A total robotic approach can be performed safely with intra-operative ICG used to demonstrate colonic perfusion as an added safety measure.
我们描述了机器人修复血管内腹主动脉瘤修复（EVAR）后 II 型内漏（T2E）的技术操作细节。我们证明，吲哚菁绿（ICG）可在术中用于证明结扎供应动脉瘤囊的肠系膜下动脉（IMA）血管后结肠的灌注。
一名 74 岁男性因 5.8cm 肾下型腹主动脉瘤接受 EVAR 治疗，使用 E-Tegra，Jotec 器械（JOTEC Gmb，Lotzenäcker 23，D-72379 Hechingen）。随后的 30 个月的监测对比 CT（CTA）证实了囊的进行性扩张。
IMA 结扎后，ICG 通过边缘确认了结肠的灌注。总手术时间 56 分钟<50ml 失血量和 1 天住院时间。3 个月随访：CTA 和超声显示 T2E 完全缓解，结肠灌注充足。
可以安全地进行全机器人方法，并使用术中 ICG 来证明结肠灌注作为附加的安全措施。
